Patient choice is everything when you’re fighting cancer. Trust me. I’ll never forget the three words that my doctor said to me when I was diagnosed. “You have cancer.” So many things rushed through my mind. How bad is it? Do I need chemo? Will I survive? And decisions had to be made. The biggest one—where do I go for treatment? After talking with family and friends and meeting with doctors at a few area hospitals, I chose care at a treatment center in Newnan. And that’s when I learned not everyone has that choice. A state law says my hospital can treat only a limited number of Georgia patients. Just 35 percent. The rest have to come from other states. I was shocked, sad, and furious. I can’t imagine being turned away from a cancer hospital because of a law.

Read Vanessa Brown-Mason’s full letter to the editor on page 5 of the DeKalb Free Press.

I can’t imagine being turned away from a cancer hospital because of a law. Luckily, I didn’t have to, but others have, and others will.

Every Georgian should have a choice in their cancer treatment…it was a deeply personal choice, and no one should be robbed of that choice because of a law. I joined Speak Now Georgia, along with other patients, caregivers and concerned citizens because we believe that Georgia patients deserve better. And I urge you to act now.

Read Speak Now Georgia advocate Marty Oxford’s full letter to the editor here.

The Georgia Department of Community Health approved Wednesday a certificate of need for a $123.9 million, 60-bed hospital in Lee County.

“In terms of quality of life and economic development, this is the best thing to happen in this part of the the state in at least a decade,” Winston Oxford, director of the Lee County Chamber of Commerce and the Lee County Development Authority, said.

The CON will not be finalized until a 30-day appeals period has elapsed, but Lee officials said they plan to move forward with infrastructure plans.

Based on comments at an opposition hearing before the Department of Community Health last month concerning the proposed Lee County Medical Center [LCMC], supporters of the Lee hospital say Phoebe Putney Health System is involved in the fight to get LCMC’s certificate of need denied.

While such claims surfaced in an LCMC answer to the opposition hearing, presented to DCH on Nov. 5, Phoebe remains firm in stating that it has not been involved in the opposition of the Lee hospital development.

But CON laws have hung around because health-care providers are a competition-averse crowd. They try to use the law to hamstring their competition wherever possible. In some instances, obtaining a state certificate of need is like being given government-sanctioned monopoly power.

What is most lamentable about the antiquated law is that it has encouraged the state’s health care providers to choose the command-and-control power of the state to exclude competitors rather than win customers over by operating the best and most efficient facilities they can.

From the Federal Trade Commission in a letter to the Georgia Department of Health: “Consistent with Georgia’s CON laws, we encourage you to foster competition that is shown to result in lower patient costs without a loss of the quality of care in order to improve the welfare of Georgia health care consumers.”

Repeated examinations by the Federal Trade Commission and the Justice Department have found that COPN (Certificate of Public Need) regimes reduce patient choice, drive up costs, and limit competition. The only parties that benefit are market incumbents such as large hospital chains.

In any event, once you strip away the bureaucratese, COPN defenders essentially are saying that because government already has imposed many restrictions on providers, Virginia needs to keep this one, too. Which is a little bit like saying the best way to avoid a hangover is to just keep drinking.

The Federal Trade Commission is not saying whether it will get involved in the process of the state of Georgia approving or denying a certificate of need for the proposed Lee County Medical Center.

Lee County officials told The Albany Herald last week that the FTC was watching the process, and the Lee County Commission has asked FTC officials to comment on the issue with the Georgia Department of Community Health, which will make a decision on the CON request.

Certificate -of -Need programs were intended to limit the supply of health care services within a state. Proponents claim that the limits are necessary to, among other things, control costs and increase the amount of charity care being provided. However, 40 years of evidence has demonstrated that these programs do not achieve their intended goals, but rather decrease the supply and availability of health care services by limiting entry and competition.

Thirty-five states and the District of Columbia have Certificate-of-Need (CON) laws governing the construction of new medical facilities. These laws give favorable treatment to major medical centers and other existing hospitals by limiting competition. The result is higher prices for patients.

It didn’t take long for Washington to realize that certificate-of- need laws weren’t bringing prices down. The federal program was abolished in 1986, and 14 states subsequently scrapped their CON programs. But hospital associations across the country work hard to maintain the market advantage that certificate-of- need laws provide, spending millions of dollars to lobby state legislators to block reform.

Piedmont Healthcare is looking to grow its Newnan, Ga., hospital by adding 18 more patient beds. The project would cost $8.2 million. According to a letter submitted to the Georgia Department of Community Health (DCH), the project will require the renovation of 11,500 square feet on the fifth floor of the hospital to create a new unit.

Piedmont currently has 136 beds. This project would bring its total to 154. But before it can kick off, Piedmont will need to file a Certificate of Need with DCH and gain the agency’s approval.

State Sen. Ben Watson, a Savannah physician, pushed a proposal in the legislature this year to extend the exemption to multispecialty centers. But the legislation drew ferocious opposition from the hospital industry in Georgia, and never got traction.

The Medical Association of Georgia said in a statement that it “supports the repeal of Certificate of Need laws in general and specifically as they apply to physician-owned and operated outpatient diagnostic centers, imaging centers, ambulatory surgical centers, laboratories and ancillary services.”

[A Georgia cancer patient discusses the importance of choosing your cancer team carefully] “After surgery in 2015, I started chemo [at a local hospital] right away. A few months in, I was so weak I couldn’t take care of myself, and the doctors I was seeing didn’t seem to know what to do.” So Marty Oxford made a bold move: She switched to a different facility, which specialized in cancer care, in the middle of chemo and radiation. “There, I was offered nutrition support, physical therapy, occupational therapy, and even acupuncture,” Oxford says. “I felt almost embarrassed to leave my other doctors — like I should apologize for choosing what was best for myself! But having a team that addressed my whole health helped me go from fighting for my life to living it.”

Rep. Sam Mims, R-McComb, chairman of the House committee, and Sen. Dean Kirby, R-Pearl, chairman of the Senate panel, and members of their committees held a three-hour hearing on the issue Monday. “We are just interested in getting the best health care we can get for the dollars we are allotted,” Kirby said after the meeting. Mims simply said “it is a big issue” that deserved the attention of his committee. Both said they would continue to study the issue. Russ Latino, the state director for Americans for Prosperity, told legislators they should repeal the certificate of need (CON) process and allow “market driven forces” to determine the number of hospitals and other health care facilities in the state. That, he said, would lead to lower costs and better care. “More competition tends to lead to higher quality,” agreed Matthew Mitchell, an economist at George Mason University, who has studied the issue and said most economists view CON laws as “anti competition.”

Jim Davis, CEO of University Health Care System in Augusta, has resigned his post as chairman-elect and board member of the Georgia Hospital Association. Davis cited the conflict between his strong opposition to the certificate of need (CON) program for health care licenses and the hospital industry’s firm embrace of the status quo.

“… We have taken the time and effort to listen to the residents of Lee County and our neighbors in surrounding counties. We’ve heard their desire for another choice for health care in Southwest Georgia. We believe in open, honest and civil discussion about issues important to our community, including the future of health care, and we would welcome the opportunity to meet with you. We will gladly host the Dougherty County Commission at a location and a date convenient to your Board. Our efforts to bring competition to the health care landscape in the form of Lee County Medical Center is not about dividing our counties or pitting our residents against each other. As leaders, we must not sow the seeds of division in Southwest Georgia. We owe our community better than that, which is why we are seeking the opportunity to talk with you directly.”

Many states attempt to keep hospitals fiscally solvent with Certificate of Need (CON) regulation. CON gives hospitals a monopoly on certain services to increase their cash flow. Unfortunately, it’s much like the saying, “If all you have is a hammer, everything looks like a nail.” CON is a very blunt instrument to address a specific fiscal problem.

The three dimensions (cost, accessibility and outcomes) were evaluated using 35 relevant metrics, including cost of medical visits, average monthly insurance premiums, physicians per capita, quality of public hospital systems, infant mortality, life expectancy among others. Georgia ranked sixth worst for health care, according to the study.

Four out of five Georgia hospitals are set to receive Medicare penalties for having too many patients returning within a month of their discharge. Of the 100 Georgia hospitals evaluated for penalties, 82 received the fines.

In Coweta County, the battle against cancer has taken on a new focus: patient choice. With both a for-profit specialty treatment facility and a nonprofit hospital cancer care option available in Newnan, health care officials have begun to question if the local community truly has a need for the two comparable practices – and if patients are actually being given the choice to decide between the two. “This is about patient choice and access,” Ray Williams said of the recent Senate Bill 123 currently being considered by the Georgia General Assembly. Williams is a lobbyist for the Cancer Treatment Centers of America, located in Newnan.

Among the surprises was that no major bill related to the certificate of need (CON) program generated legislative action. CON rules govern the expansion and creation of health care facilities and services in the state. The Cancer Treatment Centers of America sought a CON change to allow its Newnan facility to accept more Georgia patients, while a group of doctors wanted to loosen restrictions on operating a multispecialty outpatient surgery center.

HB464 seeks to amend Chapter 6 of Title 31 of the Official Code of Georgia Annotated, legislation that was introduced in 2008 and unintentionally restricted patient choice and access for Georgia cancer patients. The bill is headed to the Government Affairs committee on Monday, February 27.

SB123 seeks to remedy the unintended consequences of legislation introduced in 2008, which imposed restrictions on destination cancer hospitals and limited their in-state patients to 35 percent of their total patient base and capped the facility at 50 beds.

Imagine a local hospital being forced to turn away a cancer patient simply because they are from the state of Georgia. Cancer Treatment Centers of America says it’s a reality. Officials with the organization say they are being forced to turn Georgia cancer patients away.

The Cancer Treatment Centers of America (CTCA) remains firm in the company’s campaign for change in its Newnan operations, as new legislation to reconstruct the state’s Certificate of Need (CON) law was introduced into the Georgia Senate Wednesday.

Legislation introduced into the Georgia Senate Wednesday would remove restrictions the General Assembly imposed on Cancer Treatment Centers of America when the state allowed the company to open a hospital in Newnan, Ga., in 2008.

Here are two sides to an issue before the General Assembly in which some of the major players are from Newnan. It has to do with a Georgia law requiring hospitals and other medical facilities to convince state officials to grant a certificate of need in order to build or expand.

I’m an advocate for patient choice. Let me tell you why. I was diagnosed with stage 4 pancreatic cancer in 2012. In the blink of an eye, life changed greatly. A lot of information came our way. A lot of decisions needed to be made. And the biggest one – choosing where to get cancer care. I began treatment at a facility in Atlanta, but my health continued to decline. So did my hope. As a wife and mother of three children, I wasn’t willing or ready to give up. My family wasn’t ready. We wanted more options. I’m forever grateful for the option that came to life in our Newnan back yard the same year I was diagnosed – Cancer Treatment Centers of America.

The evidence is clear that Certificate of Need laws are harming, not helping. Patients want local, innovative and affordable health care—and only open competition, not government mandated scarcity, can deliver.

While it is true that health care in America has presented us with new and complex challenges, it is not true that policymakers must respond with their own new and complex solutions. They must, however, begin with a clear understanding of the problem. Here, it does not take much to see that making it harder for providers to enter the market will not make it easier for patients to get the care they seek.

Misguided Certificate of Need (CON) laws in 36 states restrict access to the procedure recommended by the American College of Radiology. Initially, the laws were touted as a way to cut health care costs and encourage charity care through centralized planning. In reality, they benefit providers while restricting consumers.

CON laws, when first enacted, had the laudable goals of reducing health care costs and improving access to care. However, after considerable experience, it is now apparent that CON laws can prevent the efficient functioning of health care markets in several ways that may undermine those goals. First, CON laws create barriers to entry and expansion, limit consumer choice, and stifle innovation.

Help Us Lift Restrictions on Access toCancer Care in Georgia.

Speak Now Georgia is a group of cancer patients, family members and motivated advocates fighting to give choice back to cancer patients in Georgia. We believe that every cancer patient deserves the right to choose where they seek care. Once you enter your email address, we’ll keep you informed on the latest legislative updates, news and posts on our progress.

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